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Tips for administering MR scans for autistic patients

by John R. Fischer, Senior Reporter | May 18, 2022
MRI
Autistic patients have challenges that other patients do not have that make it difficult to scan them with MR systems.
Researchers at City, University of London have devised a set of guidelines for performing MR scans on patients with autism, a condition that affects how people communicate and interact with the world.

Around 1%–2% of the general population is autistic, with the condition more prevalent in males. Autistic individuals may need to undergo MR scans for common clinical concerns, such as recurring lower back pain, persistent headaches, injury or trauma. Certain medical conditions also may be more common in autistic adults, including immune conditions, gastrointestinal and sleep disorders, epilepsy, obesity, dyslipidemia, hypertension and diabetes, along with psychological and mental health issues.

Due to their sensory sensitivities and communication preferences, scanning autistic people can be challenging due to long scanning times and narrow bores. Noise, table movements and vibrations from the machine in action can also be difficult for autistic people to process calmly and can make MR scans a daunting experience. At times, sedation may be needed.

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In a systematic review, the researchers emphasize the need for reasonable adjustments when performing MR brain scans on an autistic person to make the scan more friendly for them. These include efficient communication, simulation for familiarization with the environment, distraction techniques, and scan-based optimization.

Lead author Dr. Christina Malamateniou, postgraduate programme director for radiography at City, University of London told the European Society for Magnetic Resonance in Medicine and Biology that the study is the first to discuss reasonable radiographic adjustments for autistic adults and children in MR suites, and emphasizes the need for ensuring communication with them is clear. "It’s less distressing to the autistic individuals, in terms of the sensory sensitivities and the anxieties they may have about the scan, which is heightened and also after the scan, the aftercare and the results."

She and her colleagues suggest the following:

  • Communication: Contact autistic individuals and their parents or carers prior to exams to customize a game plan. Use letters and visual flow charts and pre-scan interviews to explain the procedure to autistic children and their patents. Allocate extra time to explain and answer questions. Have staff wear ID cards during the exam to help with face/name associations and give instructions in a calm and reassuring tone. Include parents and caregivers in the procedure to help alleviate anxiety.

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